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NPI Code Detail

MEDICARE: DAMAIN A SMITH MD

MEDICARE:   DAMAIN A SMITH  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician35074837SOH
2207V00000XObstetrics & Gynecology Physician2007-01031NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3145RCOTHERNCBCBS NC

General Provider Information

NPI Number : 1225096894
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAMAIN A SMITH MD
Provider Business Mailing Address
First Line : 245 MEMORIAL DR
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-6333
Country : US
Telephone Number : 910-353-4333
Fax Number : 910-353-6529
Provider Business Practice Location Address
First Line : 245 MEMORIAL DR
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-6333
Country : US
Telephone Number : 910-353-4333
Fax Number : 910-353-6529
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2006
Last Update Date : 04/21/2025

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Directions to “ DAMAIN A SMITH MD” Practice Location

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